Brigham and Women’s research group finds ‘pleasant surprise’: Black patients 50% more likely to utilize telemedicine than white patients

Telemedicine, which gained wider popularity during the COVID-19 pandemic and is likely to become a permanent fixture of the health care system, has become especially popular in two patient groups: Black patients and women, according to a new study out of Brigham and Women’s Hospital.

“Given the digital divide, we expected to see differences and the use of virtual care among these populations,” said Dr. Gezzer Ortega of the Brigham and Women’s Hospital’s Center for Surgery and Public Health, who authored the study, of the Black patients in particular. “But it was a pleasant surprise when we noticed that there was over-utilization within these groups.”

Ortega’s study broke its data into two phases: March 24, 2020 to June 23, 2020, during the stay-at-home advisory in the state, and the rest of the year. The goal was to compare patient appointments for different groups during that time, and determine the breakdown of in-person, video and audio appointments for new patient consultation within the hospital’s Division of General and Gastrointestinal Surgery.

Ortega said the research team chose to focus on surgeries because of the existing disparities in care and outcomes among groups for these procedures. He added that the team specifically chose to study the gastrointestinal division over other areas of medicine “because it’s one of the large divisions within our department, and it also reflects a broad population of care that we see,” he said.

During the early days of the pandemic, the study, published in the Journal of the American College of Surgeons, found little difference in the races of the people seeking care in-person or remotely, though he noted that Hispanic and Latino patients used the audio-only feature at higher rates than average, as did older patients, those with lower education levels, and those with a primary language other than English.

In the second phase of the study, which stretched from June 24 to Dec. 31, 2020, the gap for Hispanic and Latino audio-only appointments declined, likely reflecting improved digital literacy and access.

Notably, these gaps remained for the other groups throughout the study. “It’s important for us to have the flexibility of audio and video because there are certain circumstances where a patient may not have broadband access to do video, or may not have the capacity or the privacy to do a video call,” Ortega said.

Still, he said anything is better than nothing, but video calls are even better because they provide doctors with nonverbal cues impossible to read over the phone. In-person appointments, he added, are the best option.

However, the rate of use of telemedicine for Black patients was double compared to white patients, though Ortega said more research is needed to determine what those those reasons are on “a cultural nuance and personal level,” he said.

Women were also more likely to use telemedicine throughout the study, he said, which likely reflects the reality that women took on additional caretaking roles during the pandemic.

Ortega said that the study results point to the need for expanded broadband access to close health care access gaps. Digital literacy training, patient outreach to enroll in telemedicine services, and user-friendly, multilingual digital health care platforms would also help, he said.